Srettabunjong Supawon
Department of Forensic Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Feb;92(2):279-83.
This is a histological report of a myocardial lesion of a 44-year-old white man who was found dead in a hotel with circumstances strongly suggestive of heroin intoxication. Based on. autopsy findings and toxicologic analysis, the present case was an instance of straight forward heroin overdose in snorter. The most striking pathologic finding of the heart was a few patches of marked dark mottling appearance in the left ventricle and ventricular septum. Histological appearance of the lesions revealed marked congestion with intramyocardial extravasation of blood. Since the deceased had patent coronary arteries without evidence of atheroma, the lesions were thought to be the results ofcoronary artery spasm. There has also been substantial evidence in the previous reports to believe that the condition is secondary to heroin-induced coronary artery spasm. However its actual underlying mechanism remains unclear.
这是一份关于一名44岁白人男性心肌病变的组织学报告。该男子被发现死于一家酒店，当时的情况强烈提示海洛因中毒。根据尸检结果和毒理学分析，本病例为直接经鼻吸食海洛因过量致死的案例。心脏最显著的病理发现是左心室和室间隔有几处明显的暗斑。病变的组织学表现为明显充血，伴有心肌内血液外渗。由于死者冠状动脉通畅，无动脉粥样硬化证据，这些病变被认为是冠状动脉痉挛的结果。此前的报告中也有大量证据表明，这种情况继发于海洛因引起的冠状动脉痉挛。然而，其实际潜在机制仍不清楚。
